Provider Demographics
NPI:1225010374
Name:BRAENDLE, WAYNE R (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:R
Last Name:BRAENDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:370 HIGHWAY 35
Practice Address - Street 2:STE 200
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5922
Practice Address - Country:US
Practice Address - Phone:732-936-1095
Practice Address - Fax:732-936-1027
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0036507OtherAETNA HEALTH HMO
NJ1911201Medicaid
0K4743OtherHEALTH NET OF THE NE INC
4379743OtherAETNA HEALTH TRADITIONAL
NJ6102397OtherCIGNA HEALTHCARE OF NJ
NJ82A102OtherWELLCHOICE HMO OF NJ
NY82A101OtherEMPIRE BC BS OF NY
041081OtherAETNA HEALTH CAPITATION
82A101OtherEMPIRE HEALTHCHOICE INC
NJ0K4743OtherHEALTH NET OF NJ
82A102OtherEMPIRE HEALTH PLAN ASSUR
82A101OtherEMPIRE HEALTH PLAN ASSUR
NJ82A101OtherWELLCHOICE INSURANCE
NJ82A101OtherWELLCHOICE HMO OF NJ
NY82A102OtherEMPIRE BC BS OF NY
82A102OtherEMPIRE HEALTHCHOICE INC
NJ82A102OtherWELLCHOICE INSURANCE
0K4743OtherHEALTH NET OF THE NE INC
82A101OtherEMPIRE HEALTHCHOICE INC